Author(s): MALDONADO-MARTIN, S., MORANTE-SAINZ, I., TOUS-ESPELOSIN, M., OLAZABAL-EIZAGIRRE, I., MADINABEITIA, J., MARTINEZ DE RITUERTO-ZEBERIO, M., ZEBERIO-ETXETXIPIA, I., Institution: UNIVERSITY OF THE BASQUE COUNTRY (UPV/EHU), Country: SPAIN, Abstract-ID: 788

INTRODUCTION:
Despite high cure rates, Hodgkin lymphoma (HL) treatment is frequently associated with persistent toxicities that impair physical function and cardiovascular health. Declines in cardiorespiratory fitness (CRF) and adverse metabolic and inflammatory changes contribute to functional deterioration during chemotherapy. Exercise training improves fitness, but evidence remains limited in patients experiencing severe complications during active treatment. This case study aimed to describe the effects of a 20-week supervised exercise intervention on CRF, body composition, and blood biomarkers in a patient with HL undergoing chemotherapy and experiencing a severe intercurrent thromboembolic event.
METHODS:
A 57-year-old man diagnosed with stage II HL was assessed before chemotherapy treatment (T0), mid-intervention (T1, week 10), and post-intervention (T2, week 20). At week 12, the patient suffered from a "bilateral pulmonary embolism" and "deep vein thrombosis" in the right femoral vein, with medical discharge in the following week after urgent thrombectomy. The participant had 80% adherence to the exercise program and received all 4 chemotherapy cycles. Assessments: Peak cardiopulmonary exercise test on treadmill (T0, T2), body composition (bioelectrical impedance), handgrip strength, Modified Shuttle Walking Test (MSWT), and biochemical blood analysis (T0, T1, T2). Exercise intervention: Supervised combined model with low-to-high both resistance and aerobic Interval training (2 days/week).
RESULTS:
At baseline, the participant presented with class I obesity, central adiposity, low CRF (peak oxygen uptake, VO₂peak=17.7 mL∙kg-1∙min-1), adverse inflammatory profile (C-reactive protein>3 mg/L) and immunosenescence (CD4+ T/CD8+ T lymphocytes=0.79), despite preserved lean mass and muscular strength. During the intervention, body mass decreased by 7.1%, driven primarily by a sustained reduction in fat mass (-24.1%), while fat-free mass and handgrip strength were preserved. CRF improved substantially, with increases in peak exercise time (88%), VO₂peak (25%), and walking capacity in the MSWT (21%). Marked haematological and biochemical deterioration occurred at T1 during chemotherapy, including cytopenias and dyslipidemia; however, all haematological parameters normalised post-intervention, alongside improvements in lipid profile, progressive reduction in C-reactive protein, and increase in CD4+ T/CD8+ T=1.03). There was a complete metabolic remission, as evidenced by a negative PET scan, at the end of the treatment.
CONCLUSION:
In this patient with HL, supervised exercise during chemotherapy was feasible despite major clinical complications. Improvements in CRF and body composition occurred alongside transient treatment-related haematological alterations that resolved after intervention. These findings suggest that exercise may have facilitated the patient's recovery after the episode of pulmonary thromboembolism and enabled the continuation of chemotherapy.